Part 2

Determining Ethical Justification for WWS

When considering initiating wastewater surveillance testing for a specific pathogen, first determine if there is a legitimate public health purpose. For example, during disease outbreaks, WWS can help detect and track the spread of a pathogen to inform public health response. Next, ensure that all WWS activities, such as selecting targets, collecting samples, and communicating data, align with public health ethics and values. These efforts help protect individual and community privacy and avoid creating stigma among the population included in wastewater surveillance.

When evaluating the potential privacy risks and benefits of WWS, consider the scale of sample collection. Programs that collect data on a larger scale, such as sampling from a wastewater utility in a large city, pose less risk to community or individual privacy. However, they may lack the specificity and detail needed to guide targeted public health actions. To fulfill the public health purpose, such as during an outbreak, smaller scale sampling may be necessary. In these cases, the increased risk to privacy must be carefully weighed against the potential benefits to the affected population and clearly communicated to the community.

Community engagement, responsible communication, and stewardship of WWS data help reduce the risks of privacy violations and stigmatization. WWS data can reflect sensitive information about communities, and mishandling the data can lead to stigmatization. For example, if findings link a specific group or neighborhood to a disease, that community may face discrimination, economic hardship, or negative impacts on mental and emotional well-being.

Consider the Following: The decision trees below pose some questions you may ask when considering the ethical impacts of integrating a WWS program. When exploring, consider the unique needs and concerns of your organization and population. Are there other questions that would be important to ask when considering the ethical impacts of your WWS program?

Privacy

Ethical questions thought map for considering the ethical impact of your WWS program on privacy.

Stigma

Ethical questions thought map for considering the ethical impact of your WWS program on stigma..

Data Stewardship

Ethical questions thought map for considering the ethical impact of your WWS program on data stewardship..

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